Characteristics of late presenters in Bucharest

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Late presentation of HIV diagnosis is linked to increased healthcare costs, transmission rates, and poorer outcomes.
• In Romania, a significant proportion of new HIV diagnoses in 2012 were identified as late presenters.

Purpose of the Study:

• To investigate the epidemiological and clinical factors associated with late presentation of HIV in Bucharest.
• To identify characteristics differentiating late HIV presenters from early presenters.

Main Methods:

• A retrospective study of 499 newly diagnosed HIV patients (aged >18) in Bucharest between January 2012 and December 2013.
• Late presentation defined as CD4 count <350 cells/mm³ or an AIDS-defining event; advanced HIV disease (AHD) as CD4 count <200 cells/mm³.
• Statistical analysis included Mann-Whitney U, chi-square tests, and binary logistic regression for multivariable analysis.

Main Results:

• 61% of patients were late presenters (LP), and 37% had advanced HIV disease (AHD).
• Stage C disease was strongly associated with late presentation (p<0.001, OR=11.56).
• Late presentation was more common in individuals over 35 and those with heterosexual HIV acquisition.

Conclusions:

• More than half of newly diagnosed HIV patients in Bucharest were late presenters.
• Late HIV presentation was associated with older age (>35 years) and heterosexual transmission.
• Targeted screening and early diagnosis interventions are crucial, especially for at-risk populations.